Formal Sessions Research Articles

Assessing the Impact of a Note-Writing Session and Standardized Note Template on Medical Student Note Length and Quality.

To determine whether a formal note-writing session and note template for medical students (MS) during the Core Clerkship in Pediatrics (CCP) increases note quality, shortens note length, and decreases time of documentation. In this single site, prospective study, MS participating in an 8-week CCP received a didactic session on note-writing in the electronic health record (EHR) and utilized EHR template developed for the study. We assessed note quality [measured by Physician Documentation Quality Instrument-9 (PDQI-9)], note length and note documentation time in this group compared to MS notes on the CCP in the prior academic year. We used descriptive statistics and Kruskal-Wallis tests for analysis. We analyzed 121 notes written by 40 students in the control group and 92 notes writing by 41 students in the intervention group. Notes from the intervention group were more "up to date," "accurate," "organized," and "comprehensible" compared to the control group (p=0.02, p=0.04, p=0.01, and p=0.02, respectively). Intervention group notes received higher cumulative PDQI-9 scores compared to the control group (median score 38 (IQR 34-42) vs 36 (IQR 32-40) out of 45 total, p=0.04). Intervention group notes were approximately 35% shorter than the control group notes (median 68.5 lines vs 105 lines, p <0.0001) and were signed earlier than control group notes (median file time 316 minutes vs 352 minutes, p=0.02). The intervention successfully decreased note length, improved note quality based on standardized metrics, and reduced time to completion of note documentation. An innovative note writing curriculum and accompanying standardized note template improved the outcomes of medical student progress notes in multiple domains, including timeliness, accuracy, organization, and overall quality." The intervention also significantly decreased note length and time to note completion.

Induction of prediction error during memory reconsolidation strengthens recent motor skills.

This study investigated strategies based on the reconsolidation process to promote the strengthening effect of human motor memory. The aim of this study was to evaluate the influence of reactivating the memory of a newly acquired motor skill and performing interventions during its reconsolidation process on motor performance. Sixty healthy participants learned a new Sequential Visual Isometric Pinch Task - SVIPT during the first experimental session. In the second experimental session that was held on the same day, 6 hours after session 1, the participants were divided into 6 different groups. In session 2, there were distinctions between the experimental groups concerning two issues: the presence or absence of a formal memory reactivation session characterized by the execution of repetitions of the learned motor task and the execution of different types of interventions after reactivation (training with the original, slightly modified, or moderately modified motor task). All groups performed the third session to retest the learned motor skill, 24 hours after session 1. The results showed that using training with moderate task variability during memory reconsolidation provides greater motor skill performance gain when compared to repetitive training of the same learned task. Furthermore, performing a session exclusively dedicated to reactivation with the practice of the originally learned task was not a determining condition for recent motor memory reactivation, but rather the induction of prediction error during the reactivation.

776 “Doses of Human Anatomy”: A Telegram Channel Augmenting Anatomy Education

Abstract Introduction Telegram has become one of the most popular messaging applications. Its multiple features enable its use for different educational purposes. This study aimed to explore the role of a Telegram’s channel in Anatomical education. Method A Telegram channel was created and shared to first year medical students of University of Khartoum. Subscription to the channel was optional. The Thorax module was covered through different types of daily online posts and quizzes which were posted over one month, in line with the formal practical sessions. At the end of the module, an online test shared to both subscribers and non-subscribers, a feedback questionnaire and focus group discussion were used to assess the effects of the channel and students’ reflection on it. Results 336 students subscribed to the channel by the time of the test. There was a significant association between subscription status and test score (p = 0.01, t = 2.79). Frequency of viewing did not affect test score. Students reported that written posts with images and quizzes were the two most helpful types of posts. Students reported that the channel made it easier for them to understand anatomy (86.4%), aided retention of information (92%) and encouraged engagement (81.6%). Continuation of the channel was recommended by 95.2% of students. Conclusions The channel provided concise and structured material that acted as a blueprint for students during studying and exam preparations. It proved itself as a useful complementary tool for students in the anatomy module. We recommend formal integration of Telegram channels in anatomy curricula.

1241 A Review: How Is Anatomy Best Taught in Postgraduate Surgical Education?

Abstract Introduction Successful surgery relies on complete appreciation of the appropriate anatomy, with inadequate expertise noted as a key cause of surgical errors. Despite this, there are fewer formal sessions dedicated to anatomy tuition, with surgical trainees expected to be taught “at the operating table” (Older, 2004). Aim We investigated how various anatomy teaching methods were received by core surgical trainees (CSTs). Method 28 CSTs from West Midlands deanery attended a training day at Keele Anatomy and Surgical Training Centre, comprising tuition using cadavers and Primal Pictures software. Feedback forms investigating several factors, including progress through postgraduate surgical examinations, and opinions on resources used for revision, were sent out one week and 3-6 months after the session. Results Of the attending delegates, 37.9% had failed Part A MRCS, 27.6% had passed Part A, with a further 10.3% having also passed Part B. Principal resources used for anatomy revision were textbooks and videos, with question banks and anatomy apps also used. Access to cadavers was highlighted as a significant benefit, allowing for “real-life” learning, with 86% of delegates preferring anatomy tuition using cadavers outright or in combination with Primal Pictures. Conclusions The opportunity to access human specimens appears unparalleled in its ability to illustrate “real-life” anatomy. However, these are scarce resources, and require experts to facilitate tuition, creating significant limitations to providing regular and reliable teaching. Anatomy textbooks remain a consistent choice, but with the modern migration to a world permeated with a virtual presence, the internet, videos, and apps are becoming prevalent and viable considerations.

P22 A multifaceted staff-focused approach to improve urinary tract infection management in our Trust

Abstract Background Urinary tract infection (UTI) is a common diagnostic label given to patients across all medical and surgical specialties. Despite this, there is a great degree of misconception on diagnostic and management aspects of this condition. Following our Trust performance in the NHS UTI CQUIN 2022/2023, where overall compliance was 41% and 48% for quarter 1 and 2, respectively, we embarked on a project to enhance our performance by identifying gaps in knowledge that resulted in over-diagnosis and inappropriate antibiotic treatment. Objectives To optimize clinical diagnosis of UTI, reduce reliance on dipsticks in elderly and catheterized patients, and improve antibiotic stewardship. Methods We surveyed 76 healthcare workers including doctors, nurses, advanced nurse practitioners and healthcare assistants to understand baseline knowledge and explore areas that required targeted intervention. Based on the survey results, we implemented an educational awareness campaign employing formal teaching sessions on specific wards, informal interactions, UTI flow charts and posters, new antibiotic guidelines and posts on the hospital communications and social media pages Results From our survey, we identified 45% believed dipsticks were part of routine investigations, 47% performed dipsticks for catheterized patients and 79% believed that a positive dipstick in elderly patients indicated UTI. The CQUIN data involves five key parameters; including diagnosing UTIs and CA-UTI based on clinical signs and symptoms, establishing the diagnosis without reliance on dipsticks in elderly and catheterized patients, sending urine for culture and microscopy, changing or removing catheters where applicable and treating with an appropriate antibiotic. The individual compliance for each parameter was &amp;gt;60% but our overall compliance was poor. Our survey finding corroborated the initial CQUIN data in demonstrating that the major problem areas were dipstick use in elderly patients and catheterized patients and the use of inappropriate antibiotics for treatment. Following the first wave of our improvement strategies, we recorded a significant improvement in overall Trust CQUIN compliance of 51% and 58% for quarters 3 and 4, respectively, and on the wards where specific implementation strategies were carried out, an overall compliance score of 64%. Conclusions The significant improvement we have made so far highlights what can be achieved with staff-focused interventions and the impact on patient care. We intend to continue to involve various specialities across the Trust to optimize UTI management.

Informal learning in architectural education through sociomaterial approaches: Towards a network-based pedagogy in design education

Most ethnographic research on architectural education focuses on formal teaching events. It mainly analyses meetings between students and teachers in tutorial sessions, design reviews, and formal presentations. Architectural knowledge, however, is also acquired informally between formal academic sessions. This study focuses on informal design-learning processes within formal architecture academic courses. Our data were collected during eight months of ethnographic study in an immersive masters-level architecture programme. We analysed our data using a macro-level inductive methodology and interpreted our findings using a sociomaterial theoretical approach. This paper offers two types of contributions. Theoretically, it contributes to our understating of informal learning processes in architectural education by demonstrating how different actor network compositions and dynamics affect informal learning. Pedagogically, it re-evaluates the role of the design instructor within a broader context of actors working together to produce knowledge and develops a network approach to design education.

A preceptor development program using an interactive board game

Background and purposeColleges and schools of pharmacy and residency programs must be engaged in the purposeful development of their preceptors. Preceptor development needs vary widely from a new preceptor needing foundational preceptor skills to a more experienced preceptor who may wish to incorporate more sophisticated precepting methods such as layered learning or interprofessional precepting. It can be challenging to create preceptor development activities that meet these varied needs and keep preceptors of all levels engaged. Educational activity and settingThe Preceptor's Game of Life was developed to incorporate serious gaming into preceptor development to increase engagement and promote learning across all precepting levels. This game was designed to review precepting fundamentals and focused heavily on the application of these principles to authentic precepting scenarios. An element of friendly competition, collaboration, and storytelling created a safe and fun environment where participants could discuss solutions to scenario-based problems. FindingsThe Preceptor's Game of Life has been well received by state and national audiences. Audience members were engaged and invested as they discussed the scenarios presented. Individual, informal feedback following the session and formal session evaluations were positive. SummaryThough the Preceptor's Game of Life required careful logistical planning, the outcome was positive. High levels of engagement amongst the participants were noted in the form of note taking and audience participation. Audience members appreciated activating their prior knowledge and experiences and applying that to future scenarios. This manuscript serves as a tool for others interested in novel preceptor development methods.

Optimizing Education During Pediatric Resident Mock Code Sessions.

Most pediatric residents have limited opportunities to manage cardiac arrest. We used simulation to fill that educational void. Given work hours and other obligations, resident education sessions must be high-yield. We examined the effectiveness of adding varying amounts of formal education to a mock code session on resident knowledge and confidence in managing pediatric cardiac arrest compared with participation alone. Convenient groups of 3 to 8 pediatric residents completed a simulation session with the identical scenario: a 3-month-old infant with pulseless ventricular tachycardia and then pulseless electrical activity. All residents completed pretests and posttests, which consisted of open-ended knowledge questions from the American Heart Association Pediatric Advanced Life Support guidelines and confidence Likert scale assessments. Resident groups were assigned to 1 of 3 educational models: experiential-only: participation in the mock, traditional: mock code participation with standardized education after the mock code, or reinforced: standardized education before and after mock code participation. Ninety-five residents participated. Collectively, residents demonstrated a median 2-point (interquartile range, 1-4) increase in knowledge (test maximum score, 10) after they attended a mock code simulation session ( P < 0.0001); however, there were no statistically significant differences noted between educational modalities. All residents also demonstrated a 4-point median increase in confidence (test maximum score, 25) after completing their simulation session (interquartile range, 3-6) ( P < 0.001), but no differences were seen by type or amount of accompanying education. Residents had gains in confidence and knowledge of pediatric cardiac arrest management after participation in the mock code. Formal educational sessions and reinforced formal education sessions accompanying the mock code did not significantly increase knowledge or confidence.

Knowledge Regarding Evidence-Based Guidelines on Ventilator-Associated Pneumonia Prevention Bundle among Critical Care Nurses

Background: In critical care units, ventilator-associated pneumonia is still a frequent and possibly fatal consequence of ventilator therapy. Choosing the most urgent care and knowing how to prevent ventilator-associated pneumonia may help nurses become more alert, which will improve the quality of care and prevent a serious problem in Nepal. Thus, this study aimed to assess the knowledge regarding evidence-based guidelines on ventilator-associated pneumonia prevention bundle among critical care nurses.&#x0D; Materials and Methods: Data were collected through a self-administered structured questionnaire using the non-probability total enumerative sampling technique among 132 critical care nurses. Data analysis was carried out using SPSS version 20. For descriptive statistics frequency, percentage, mean, and standard deviation were calculated. For inferential statistics, the Chi-square test was used to find out the association between the levels of knowledge regarding Evidence-Based Guidelines on the VAP Prevention Bundle among Critical Care Nurses.&#x0D; Results: One hundred and thirty-two critical nurses participated in this study. 51.5 % had a poor level of knowledge, whereas, 45.5 % had an average level of knowledge and only 3.0 % had a good level of knowledge. There was a statistically significant association between the level of knowledge and the respondents’ working experience.&#x0D; Conclusion: According to the study's findings, the majority of respondents had inadequate knowledge. Regular formal training and interactive educational sessions are required to evaluate knowledge of the VAP prevention bundle, particularly in light of the high nurse turnover rate.

Differentiated instruction in the EFL classroom: An interview study on Hungarian primary and secondary school EFL teachers' views and self-reported practices

AbstractIn recent decades, there have been growing expectations for language teachers to use differentiated instruction (DI) in their classrooms to address the diverse needs of their students. Currently, however, relatively little is known about how teachers of English as a foreign language (EFL) working in Hungarian public education view the concept of DI and implement it in practice. The present study sought to explore this question by interviewing eight Hungarian primary and secondary school EFL teachers on their views and practices of DI. More specifically, the study strove to explore the participants' understanding of and attitude towards DI as well as the differentiation strategies they report to use and the challenges and enablers they perceive when implementing DI. The data were subjected to template analysis. Results suggest that teachers have a solid understanding of the goals of DI and show a primarily positive attitude towards the approach but are less conscious about the strategies available to them and tend to differentiate mostly intuitively. They perceive challenges both in planning and delivering differentiated lessons, such as coping with increased preparation time and having to multitask in class. Exchanging good practices in formal and informal training sessions, cooperating with colleagues and parents, and having rearrangeable furniture and digital tools in the classrooms emerged as enablers of DI. Implications point toward the need for professional development opportunities that help teachers conceptualize their intuitive approaches and extend their repertoire of DI strategies. Researching how technology may enhance DI practices also appears to be warranted.

Reflections and Thoughts on the Future of Science From AGU Hydrology Section Fellows

AbstractAt the inaugural Frontiers in Hydrology Meeting in San Juan, Puerto Rico in the summer of 2022, the Hydrology Section organized a poster session and invited our 2020 and 2021 Classes of AGU Fellows, with the initial goal of both celebrating their careers as well as to provide an opportunity for an informal exchange and connection between the section's early career members and our more senior and established scientists and engineers. Due to the challenges of time zones, virtual poster presentations and other logistics, the formal poster session was adjourned but continued as a hybrid “meet‐up” with six of our Section's Fellows (Suzanne Anderson, Paul Brooks, Aaron Packman, Remko Uijlenhoet, Andrew Western, and Xubin Zeng) from around the world. As you will see, what started as an informal chat quickly took deep dives into pressing issues in our section and science in general, including thoughts on how our community values (or in some cases doesn't value) multi‐ and interdisciplinary accomplishments, critiques of our system of rewards and awards including how we assess publication impacts and finally, a frank and honest discussion of our current efforts to diversify our community and where/why are we still failing. We hope that by sharing this open and impromptu dialogue that these discussions can expand to our entire community, and to encourage future Fellows exchanges such as this to reach our entire community of scientists and engineers.

Compassion, collaboration, and community: Strategies for staff well-being.

Compassion, collaboration, and community: Strategies for staff well-being.

Midclerkship Feedback Quality Improvement via Introduction of Simple Form (P3-2.004)

<h3>Objective:</h3> The provision of formative midpoint feedback in clerkships is required under Accreditation Standard 9.7 of the Liaison Committe on Medical Education (LCME). Our institution uses an end of clerkship evaluation by the medical students to evaluate education program quality (LCME Standard 8.5). The Clerkship Director aimed to improve the perceived quality of mid-clerkship feedback by introducing a form to prompt students to undergo specific discussion of strengths and weaknesses at the end of the first week of the clerkship. <h3>Background:</h3> The Neurology Clerkship at New York Medical College is a four-week required third year medical school clerkship with 4 clinical sites. The largest clinical site is Westchester Medical Center (WMC) with typical enrollment of 10 students per month. <h3>Design/Methods:</h3> Students scored the quality of mid-clerkship feedback on a Likert scale from 1–5, with 5 being best, during their end of clerkship evaluation. Starting in Block 8 (February 2022), a mid-clerkship preparation form was given to students which asked students to solicit individualized feedback from their resident and attending physician preceptors. Students were prompted to list two strengths and two areas to work on. They brought the paper to the formal mid-clerkship feedback session with the Site Director during week 2. <h3>Results:</h3> The average score on the Likert scale for mid-clerkship feedback quality was 3.58 in the 3 blocks preceding the change and 3.71 in the 3 blocks following the change. <h3>Conclusions:</h3> Structured interview tools can improve mid-clerkship feedback experience. <b>Disclosure:</b> Dr. Fekete has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Neurocrine Biosciences, Inc.. Dr. Fekete has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Acorda, Inc.. Dr. Fekete has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Abbvie. Dr. Fekete has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Teva Neuroscience, Inc.. Dr. Fekete has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Acadia Pharmaceutical, Inc.. Dr. Fekete has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Kyowa Kirin, Inc.. Dr. Fekete has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Adamas Pharmaceutical, Inc.. Dr. Fekete has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Neurocrine Biosciences, Inc.. Dr. Fekete has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Amneal Pharmaceuticals, Inc.. Dr. Fekete has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Acorda Therapeutics, Inc.. Dr. Fekete has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sunovion, Inc.. Dr. Fekete has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Medlink, Inc.. The institution of Dr. Fekete has received research support from Lundbeck. Dr. Fekete has received publishing royalties from a publication relating to health care. Dr. Fekete has a non-compensated relationship as a Neurological Working Group Member with Alliance for Patient Access that is relevant to AAN interests or activities.

Pediatric Delirium: An Overlooked Diagnosis?

BackgroundDelirium is well-recognized in adult inpatient care. However, it is often overlooked in children, being mistaken for pain, anxiety, or age-appropriate agitation. MethodsTo assess the impact of a formal teaching session on the diagnostic rates and management of pediatric delirium (PD) in a tertiary care center, we conducted a retrospective chart review of all hospitalized children diagnosed with PD between August 2003 and August 2018 at the CHU Sainte-Justine (Montreal, Canada). Diagnostic incidence and management were compared before (2003 to 2014) and after (2015 to 2018) a formal teaching session provided to pediatric residents, staff pediatricians, and intensive care physicians in December 2014. ResultsThe two cohorts displayed similar demographics, PD symptomatology, PD duration (median: 2 days), and hospital stay duration (median: 11.0 and 10.5 days). However, we saw a major increase in diagnosis frequency after 2014 (from 1.84 to 7.09 cases/year). This increased diagnostic rate was most striking in the pediatric intensive care unit setting. Although symptomatic treatment with antipsychotics and alpha-2 agonists was similar between the two cohorts, patients diagnosed after 2014 were more often weaned from offending medications (benzodiazepines, anesthetics, and anticholinergics). All patients recovered fully. ConclusionsFormal teaching on the symptoms and management of PD was associated with an increase in diagnostic rate and an improved management of PD in our institution. Larger studies are required to assess standardized screening tools that may further enhance diagnostic rates and improve care for children with PD.

Mental Health Issues for Frontline Hospital Staff During Height of Covid Pandemic 2020

AbstractIntroductionWhen the SARS-Cov2 virus hit the New York and New Jersey metropolitan area in Spring 2020, hospitals and hospital workers were hit hard with a new unknown pathogen that either killed people or made them very ill. There were large numbers of severely ill patients that strained resources. Hospital workers had extraordinary stress with multiple additional patients, the need to use personal protective equipment (PPE) in short supply, and faced with a pathogen that had no treatments beyond care and support initially.MethodsWe surveyed our hospital workers in late Spring 2020 to identify the main stressors and find out what measures were helpful. An online anonymous survey included questionnaires about sleep, mood, outside stressors, helpful measures, and how they coped generally. All levels of hospital workers were surveyed. Resources were provided to all respondents.ResultsOver 240 individuals responded to the survey; most respondents were women (76%). ‘Workplace stressors’ topped the chart for 98 of our respondents. The worst workplace stressor that was cited was ‘irritable workforce,’ but ‘lack of ‘protocols’ and ‘shortage of PPE’ were also cited as stressors. ‘Other’ (not described) and ‘taking care of an ill relative’ were rated highly. Those who had ‘symptoms everyday:’ Anhedonia (loss of pleasure or interest), 13%; feeling down and hopeless, 12%; sleep disturbance, 41%; low energy, feeling tired, 29%; appetite disturbance, 26%; poor concentration and attention, 15%. Respondents told us what resources they used and what was most helpful; exercise was most frequently cited as helpful.Lessons Learned and DiscussionVarious resources for formal and informal mental health support were provided to all respondents at the time of survey. Our hospital mounted its own response with support services, as did our medical school and university. A "warm line" was available through the Department of Psychiatry from late March 2020; tip sheets and online groups were widely circulated; State Department of Health provided resources. There were formal peer support sessions and workers helped each other. Medical students provided child care, shopping, and transport. We learned that extra support for workers and more frequent rest and recharge time are important. A weekly "town hall" was instituted and a weekly update about the hospital and support in healthy activities are widely circulated to employees. Those with active PTSD (some were very disturbed by the number of deceased patients) were referred to professional providers. Hospitals need to be ready to deal with epidemics and pandemics more effectively in order to mitigate stress and support workers. Being prepared, not just with equipment, but with protocols in how to proceed should another pandemic come. We learned that listening to workers is important. Workers also need to know how valued they are.FundingDepartment of Psychiatry, New Jersey Medical School

Learning and community building in support of collective action: Toward a new climate of communication at the COP

AbstractThe international UN Climate Change conferences known as “Conferences of the Parties (COPs)” have an enormous convening power and are attended annually by tens of thousands of actors working on climate change topics from a wide range of perspectives. In the COP spaces outside of the formal negotiations, the communication culture is dominated by “side events,” a format that relies heavily on conventional presentations and panels that can be informative, but is generally not conducive to mutual engagement, reflection, or dialogue. There is an urgent need for new dialogue formats that can better foster learning and community‐building and thereby harness the enormous latent potential for climate action represented by the diverse stakeholders that gather at the COP. Against this backdrop, and drawing on our experience with the development and implementation of the Co‐Creative Reflection and Dialogue Spaces at COP25, COP26, and COP27, we make recommendations for further developing the communication culture of the COPs. At the level of individual sessions, we provide recommendations for designing participatory dialogues that can better support reflection, interconnection, and action orientation. In addition, we offer guidance for scaling up these practices, for instance through networks and communities of practice to support a shift of the overall communication culture of the COPs. Our recommendations focus on interactions and exchanges that unfold outside of the formal negotiation sessions, with a view toward enabling and accelerating transformative action by non‐state actors.This article is categorized under: Perceptions, Behavior, and Communication of Climate Change &gt; Communication Policy and Governance &gt; International Policy Framework

23. Creating and Implementing a Wellness-inspired Resident Educational (WIRE) Curriculum

Background: More than 70% of surgical trainees reported symptoms of burnout prior to the start of the COVID-19 pandemic. Unaddressed, burnout can result in diminished quality of life, reduced career satisfaction, decreased productivity, and elevated risk of suicidality, especially amongst physicians. Traditional plastic surgery residency curricula have not addressed physician burnout or strategies for managing its sequelae. Methods: Our department create and implemented the Wellness-Inspired Resident Education (WIRE) curriculum. The goals of this initiative are to prepare residents for life after residency, provide residents and faculty with the tools necessary to maximize their personal wellness, and create opportunities for networking with leaders in the field. Feedback obtained from residents who participate in our curriculum is used to shape the following year. Results: The WIRE curriculum was initiated in March 2021 consisting of a leadership retreat and 1-2 wellness lectures per month. Feedback obtained from residents who participated in the sessions indicated a desire for improved balance between educational and wellness inspired didactic sessions, in addition to creating better integration of the sessions such that personal time was not further affected. In the following year, 6 topics were chosen, including three resident-selected topics. Sessions were held on a bimonthly basis and were fully integrated into the didactic schedule. Additionally, a resident wellness retreat was planned for the Fall. Residents were surveyed following conclusion of the academic year, with 90% of residents indicating a desire for more informal wellness events in addition to formal sessions as part of the planned curriculum. Resident-selected topics with more than 50% interest amongst surveyed residents included malpractice, financial planning, recovering from complications and bad interactions, making an impact, mentoring, innovation and invention, conflict resolution, and ergonomics. Conclusion: The WIRE curriculum is an opportunity to better prepare trainees for life after residency and to improve everyday wellness. This curriculum is resident-driven, allowing topics to reflect interests and respond to current and potential future stressors of trainees, while increasing resident buy-in. It is our hope that this curriculum be considered as an addition to plastic surgery training programs across the country.

Approach to acute psychosis in older adults.

Approach to acute psychosis in older adults.

Research Integrity Supervision Practices and Institutional Support: A Qualitative Study.

The online version contains supplementary material available at 10.1007/s10805-022-09468-y.

Relation of non-exercise walking activity with exercise performance in patients with peripheral artery disease: NEW activity for PAD

IntroductionCommunity-based structured exercise training (CB-SET) programs are beneficial for patients with peripheral artery disease (PAD). However, the impact of lower levels of walking activity accumulated separately from formal exercise is unclear. The aim of this study was to determine the relation of non-exercise walking (NEW) activity with exercise performance in PAD. MethodsThis was a post hoc analysis from twenty patients with PAD enrolled in a 12 week CB-SET program using diaries and accelerometry. Formal exercise (3 sessions·week−1) was detected using patient-reported diary entries that corresponded with accelerometer step data. NEW activity was characterized as steps completed over five days each week, excluding steps achieved during formal exercise sessions. The primary exercise performance outcome was peak walking time (PWT) assessed on a graded treadmill. Secondary performance outcomes included claudication onset time (COT) from the graded treadmill and peak walking distance (PWD) achieved during the six-minute walk test (6MWT). Partial Pearson correlations evaluated the relation of NEW activity (step·week−1) with exercise performance outcomes using exercise session intensity (step·week−1) and duration (min·week−1) as covariates. ResultsNEW activity demonstrated a moderate, positive correlation with change in PWT (r=0.50, p=0.04). Other exercise performance outcomes were not significantly related to NEW activity (COT: r=0.14; 6MWT PWD: r=0.27). ConclusionsA positive association was demonstrated between NEW activity and PWT following 12 weeks of CB-SET. Interventions to increase physical activity levels outside of formal exercise sessions may be beneficial for patients with PAD.